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Clin Biochem. 2015 Mar;48(4-5):340-6. doi: 10.1016/j.clinbiochem.2014.09.005. Epub 2014 Sep 16.

Comprehensive biomarker profiling in patients with obstructive sleep apnea.

Author information

1
Division of Cardiology, University Hospital Basel, Switzerland; Division of Cardiology, Kantonsspital St. Gallen, Switzerland. Electronic address: micha.maeder@kssg.ch.
2
Division of Respiratory Medicine, University Hospital Basel, Switzerland.
3
Division of Internal Medicine, University Hospital Basel, Switzerland; Department of Emergency and Critical Care Medicine, City Hospital Nuremberg, Germany.
4
Singulex, Inc., Alameda, CA, USA.
5
Division of Cardiology, University Hospital Basel, Switzerland; Division of Internal Medicine, University Hospital Basel, Switzerland.
6
Division of Respiratory Medicine, University Hospital Basel, Switzerland; Division of Respiratory Medicine, Kantonsspital St. Gallen, Switzerland.
7
Division of Cardiology, Kantonsspital St. Gallen, Switzerland.

Abstract

OBJECTIVES:

The pathophysiological links between obstructive sleep apnea syndrome (OSAS) and cardiovascular mortality are incompletely understood. We aimed to contribute to a better characterization by using comprehensive biomarker profiling quantifying hemodynamic cardiac stress, cardiomyocyte injury, inflammation, endothelial function, matrix turnover and metabolism.

DESIGN AND METHODS:

In 65 patients with moderate or severe OSAS [apnea-hypopnea index (AHI) 39±20/h] and 33 patients with no or mild OSAS (AHI 8+4/h), B-type natriuretic peptide (BNP), N-terminal-pro-BNP (NT-proBNP), high-sensitivity cardiac troponin I (hs-cTnI), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), and insulin were measured before and after sleep. In a subgroup measurements were repeated in a second night with continuous positive airway pressure (CPAP).

RESULTS:

Patients with moderate/severe OSAS had higher insulin before sleep [median (interquartile range), 36.4 (21.9-52.1) vs. 20.8 (10.6-32.8)mU/mL; p=0.006], higher IL-6 after sleep [1.00 (0.73-1.58) vs. 0.72 (0.48-0.94)pg/mL; p=0.005], and larger relative overnight reduction in BNP [-9 (-35-0) vs. -3 (-21-13)%; p=0.04] than those with mild/no OSAS. Insulin before sleep was the only independent predictor of moderate/severe OSAS. Insulin before and IL-6 after sleep were independent predictors of severe OSAS, and when combined provided high diagnostic accuracy for severe OSAS (area under the receiver operator characteristic curve 0.80; 95%-confidence interval 0.69-0.91). In contrast, there were no significant differences in NT-proBNP, hs-cTnI, VEGF, and MMP-9 between moderate/severe and mild/no OSAS. Short-term CPAP had no impact on biomarker concentrations before and after sleep.

CONCLUSIONS:

Significant OSAS is characterized by a distinct biomarker profile including high insulin before and high IL-6 after sleep.

KEYWORDS:

Biomarkers; Diurnal changes; Multimarker; Obstructive sleep apnea syndrome

[Indexed for MEDLINE]

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